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1477076248
JOSHUA ALLAN MODICA
SAN ANTONIO, TX
NPI
1477076248
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT5670)
Enumeration Date
2017-07-24
Last Update Date
2017-07-24
Business Address
JOSHUA ALLAN MODICA ATC, LAT
ONE UTSA CIRCLE
SAN ANTONIO, TX 78249-1644
Phone number: 417-379-5908
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Mailing Address
JOSHUA ALLAN MODICA ATC, LAT
20319 LIATRIS LN
SAN ANTONIO, TX 78259-2250
Phone number:
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